ArticleClinical journal of the American Society of Nephrology : CJASN2026
Uncovering Chronic Disease Disparities within Compacts of Free Association Migrant Populations in Hawaii.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Kidney Disease among the Compacts of Free Association Pacific Islander Community: A Hidden Crisis.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Historical events including US neocolonial administration and thermonuclear weapon testing within their homelands left many Compacts of Free Association (COFA) citizens, including those of Chuukese, Marshallese, Pohnpeian, Yapese, and Kosraean descent with poor health and educational outcomes that led to their migration to Hawaii. A case-control study was conducted to quantify relative prevalence and severity of chronic diseases among COFA-affiliated patients compared with age- and sex-matched controls. Inclusion was based on a Preferred Language labeled as a COFA-affiliated language in the electronic health record. Cases and controls had received primary care at The Queen Emma Clinics, a hospital-embedded, mission-based clinic in Honolulu between January 1, 2018, and August 10, 2023. In comparison with the age- and sex-matched control group ( n =1076), patients with COFA-affiliated Preferred Languages ( n =353) had prevalence rates of diabetes mellitus two-fold higher (54% versus 28%), CKD 1.8-fold greater (24% versus 14%), and history of stroke two-fold greater (13% versus 7%; all P < 0.001). The prevalence of uncontrolled diabetes in the studied population was more than three-fold higher (16% versus 5%) and kidney failure was 3.9-fold higher than that of the control group (10% versus 3%). COFA-affiliated clinic patients had lower engagement with medical services on various indicators. COFA migrants in the United States present to primary care with uniquely prevalent and advanced chronic diseases, especially type 2 diabetes mellitus and CKD.
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